Projects

Background:

Under-nutrition in children younger than five years old continues to be a problem in developing countries around the world. It contributes to as much as 55% of childhood deaths globally and the loss of approximately 12 million children each year. India bears the largest burden of childhood under-nutrition in the world. Despite recent economic growth and long-standing government interventions, the prevalence of childhood under-nutrition in India has not improved much since 1990. The influence of India’s unique combination of social factors on childhood under-nutrition could be partially responsible for these abnormally high child under-nutrition rates and lack of significant improvement.

Infant feeding practices, knowledge of the etiology of under-nutrition, women’s empowerment, parental education level, gender bias, birth order, son preference, domestic violence and healthcare seeking attitudes are just a few of the social factors that potentially influence under-nutrition in Indian children. In order to achieve the first Millennium Development Goal by 2015, it is imperative that social factors are closely examined and incorporated into any government initiative addressing child under-nutrition.

Although several social factors that negatively impact child under-nutrition have already been identified, there are many more that remain unknown. By taking a broad, qualitative look at cases of under-nutrition, IndiaCLEN in collaboration with Government of India and support from USAID, WHO and the NIPI, will help to identify the unknown social factors that are preventing the reduction of under-nutrition among children in India.

Objectives:

The study will capture community perceptions about under-nutrition among children to:

• Identify social factors for under-nutrition beyond the widely perceived factors of poverty and food deprivation in the rural and urban poor communities
• Identify nutrition practices in urban slums and rural areas, contributing to high prevalence of under-nutrition
• Assess mother’s knowledge with regards to identification of under-nutrition and home based management practices for undernourished children
• Assess health seeking behavior of families for undernourished children and compliance with any advice given by health personnel
  

• Evaluate processes involved in planning, management and inter-sectoral coordination in MJSSA (JSY)
• To identify the strengths and limitations, problems faced and local innovations of the program
• To assess social mobilization strategies in place to create awareness and increase MJSSA (JSY) demand in the community

• Determine the perspective of health providers in public and private health system at different levels for causal linkages of under-nutrition in under 5 children
• Determine current management practices and document facilities for nutritional rehabilitation of undernourished children at CHCs and district hospital of the study area
  

Key Areas of Investigation:

1. National orientation and finalization of instrument workshop
2. Regional Training Workshop
3. Data collection and analysis
4. Draft Report Writing
5. Dissemination of results
6. Final Report and Submission of article for publication

Time Line:

1. Instrument development (October, 2008)
2. National orientation and finalization of instrument workshop (December, 2008)
3. Regional training workshop (January, 2009)
4. Data collection (January – March, 2009)
5. Data analysis (April- June, 2009)
6. Draft report writing (June- July, 2009)
7. Dissemination of results (August, 2009)
8. Final report (September, 2009)
9. Submission of article for publication (October, 2009)

Geographical Focus:

Uttar Pradesh, Jharkhand, Bihar, Madhya Pradesh, Orissa, and Rajasthan

Key Stakeholders:

The Norway-India Partnership Initiative (NIPI), the World Health Organisation and the Ministry of Health and Family Welfare and Department of Women and Child Development in six focus states

Expected Outcome / Output:

• Social factors and hospital treatment that impact child under-nutrition in India will be identified.
• Findings will assist in reforming public health policy and tailor government interventions to more effectively reduce the prevalence of child under-nutrition in India.
• Nutrition and health policies and programs will draw on science and technology for nutritional improvement, strengthening their implementation, awareness to community, increasing their coverage, developing social mobilization strategies on nutritional aspects.
• The recommendation will focus programs on girl’s health and nutrition.
  

Population Foundation of India, B – 28, Qutab Institutional Area, Tara Cresecent, New Delhi – 110 016		IndiaCLEN Office No. 16.8, Plot No. 172, 22nd Cross Street, Indira Nagar Adyar, Chennai – 600020